TITLE:
Volvulus of the Sigmoid Colon without Necrosis: Therapeutic Aspects in Hospital Fousseyni Daou Hospital in Kayes, Mali
AUTHORS:
Lamine Issaga Traore, Sidy Sangare, Mamaye Kouyate, Gaoussou Sogoba, Drissa Katile, Adama S. Diakite, Lassana Goita, Sadio Dembele, Djibril Traore, Drissa Traore
KEYWORDS:
Volvulus without Necrosis, Surgical Technique, Comorbidity, Morbidity, Mortality
JOURNAL NAME:
Surgical Science,
Vol.13 No.12,
December
30,
2022
ABSTRACT: The
volvulus of the sigmoid is known since ancient Egypt. In the 5th century BC, hippocrates
laid the foundations for its management. The first observation of this
condition was not reported until 1836 by Von Rokitansky, and then in 1859,
Melchior described its physiopathological consequences. It was the Norwegian
Brusgaard who reported, for the first time, in 1947, the effectiveness of a
non-operative treatment. Purpose: Describe morbidity, mortality and the
impact of co-morbidity factors on the choice of operative techniques. Patients
and Methods: This is
a retrospective cross-sectional study performed at the Fousseyni Daou Hospital
in Kayes from January 2014 to December 2021. We included all patients operated for sigmoid volvulus without necrosis.
The parameters studied were the comorbidity factor, surgical modalities,
morbidity and mortality. Results: We collected 31 patients, of whom 29 were men and 2
were women, for a sex ratio of 14.5. The mean age was 55 years with extremes (29
- 78 years). Sigmoidectomy with
colorectal anastomosis was performed in 19 cases (61.3%), the average age
of these patients was 46.16 years, the comorbidity factor was 1 case (3.2%),
the postoperative course was simple in 12 cases (63.1%), the morbidity was 6
cases (26.3%) and mortality 1 case (3.2%). Untwisting
with colopexy was performed in 11 cases (35.5%), the average age was 65.91
years, comorbidities were present in 9 cases (82%), the postoperative course
was simple in 9 cases (82%), morbidity was 1 case (9%) and mortality 1 case
(9%). Hartman colostomy was performed
in 1 case (3.2%), the age was 60 years, the morbidity was nil. Overall, the
postoperative course was simple in 22 cases (71%), the overall morbidity was 7
cases (22.6%) and mortality 2 cases (6.4%). Conclusion: At the end of our study, we can note that the
choice of the operative technique for the volvulus of the sigmoid without
necrosis can be influenced by the presence of major comorbidity and the
morbi-mortality depends on it.